Moore's Family Care Home 1

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

FCL-008-016 Issued in NC

Legal business name

MOORE'S FAMILY CARE HOME 1

Practice address

231 Morris Ford Rd
Colerain, NC 27924-9172

Phone

(252) 356-2197

Fax

(252) 356-4527

NPI assigned

Jan 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Ava Moore-Daniels

Title

Owner, Administrator

Phone

(252) 356-2197

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Ava Moore-Daniels2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ava Moore-Daniels

  dba Moore's Family Care Home

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Powellsville, NC
  • NPI 1528112364
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457405375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 MORRIS FORD RD",
            "city": "COLERAIN",
            "state": "NC",
            "postal_code": "279249172",
            "telephone_number": "252-356-2197",
            "fax_number": "252-356-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 MORRIS FORD RD",
            "city": "COLERAIN",
            "state": "NC",
            "postal_code": "279249172",
            "telephone_number": "252-356-2197",
            "fax_number": "252-356-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE'S FAMILY CARE HOME 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE-DANIELS",
        "authorized_official_first_name": "AVA",
        "authorized_official_title_or_position": "OWNER, ADMINISTRATOR",
        "authorized_official_telephone_number": "252-356-2197",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "FCL-008-016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804790",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Humble Spirit Foundation
• Integrity Home Healthcare
• Crystal Jacobs
• Whitley Arvis Lawrence, FNP-C
• Life Design Services, Inc.
• New Horizons Community Support Services, Inc.
• New Horizons Community Support Services, Inc.
• Vickie M Persaud
• Tiffany Kathryn Pierce Lassiter, RN
• Roanoke Chowan Community Health Center Inc (CPC Pharmacy)

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Colerain, NC
• Providers in Colerain, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.